Community of Practice Updates

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NSSP CoP Monthly Meeting

The National Syndromic Surveillance Program (NSSP) Community of Practice (CoP) held its monthly meeting on July 27, 2022. On average, 100 to 120 people participate in these meetings. Recordings for the monthly CoP calls are posted in the Knowledge Repository. You can access this month’s recording directly.

 Featured Presentations

  • Data Modernization Initiative: How DMI Applies to NSSP (Karl Soetebier, CDC NSSP)
    NSSP is unique in that it has automated data sources that deliver results in near real-time. Karl described NSSP’s goal to strengthen infrastructure by improving the current platform cloud architecture and by implementing an alternative cloud architecture. NSSP is also working to modernize the ESSENCE user interface. At the same time, NSSP plans to increase the number of facilities and fill gaps in emergency department data; improve the quality of its data monitoring tools; and complete its integration of mortality data while adding new data sources (e.g., data from National Notifiable Diseases Surveillance System, COVID-19 electronic laboratory reporting data).
  • Firearm Injury Surveillance Through Emergency Rooms (FASTER) Program (Marissa Zwald, CDC)
    FASTER aims to increase the timeliness of aggregate reporting of emergency department visits for nonfatal firearm injuries and to share surveillance findings with key stakeholders who work to prevent (or respond to) firearm injuries. Marissa introduced 10 public health jurisdictions that receive FASTER funding. She described the syndrome definitions that FASTER uses and ways in which FASTER data are already being used, showed examples (Virginia Data Dashboard for Firearm Injury Surveillance, Georgia Data Dashboard for FASTER, North Carolina FASTER factsheet), and described state partnerships that make strategic use of FASTER data. She concluded by describing comprehensive data validation studies being done and the plans for raising awareness of FASTER.
  • ESSENCE Syndrome Definition: Suicide Attempt v2 (Eva Trinh, CDC; Nilay McLaren, SWEP student)
    Eva explained that Suicide Attempt v1 was revised because, in practice, it did not adequately distinguish between non-suicidal self-harm and true suicide attempts. She described the process for revising the syndrome definition, which involved a highly iterative process and much more user feedback. Presentation visuals included a decision tree for reworking the query structure and removing inappropriate visits. The presentation concluded with statistical comparison of visits captured by each query. Next steps call for further refinement of suicide attempt v2, publication of v2 on ESSENCE, tracking v2 results over time, and expansion of funding opportunities.

NSSP Updates

Karl Soetebier, acting NSSP lead, acknowledged the fine work being done by the NSSP Community of Practice and the NSSP team—from surveillance of pediatric hepatitis, mpox, and localized instance of polio to continued data collection and analytics that inform CDC’s response efforts. Karl encouraged community members to take part in the subcommittee and workgroup calls and Slack conversations to stay engaged and aware of health events.

  1. Karl announced two opportunities to participate in user acceptance testing (UAT). This is a valuable way to preview features, improve NSSP capabilities and tools, and help the NSSP team ensure that the work being done will meet your everyday and emergency response needs. The first is an opportunity to support UAT for the NSSP BioSense Platform. The UAT will inform the BioSense Platform 2.8 release, which is scheduled for deployment on September 22, 2022. Release 2.8 includes a range of enhancements to the Access & Management Center (AMC) and Data Quality (DQ) Dashboard. UAT participants will be asked to test new AMC capabilities for managing users, including an alternate workflow for granting data access and reporting on user groups, improvements to required fields, feature for setting banner notifications, and improved support for associated facilities. Enhancements to the DQ dashboard will include an improved user experience and support for data quality alerting.
    Time Required: About 90 minutes; only a few volunteers are needed.
    How to Volunteer: Volunteers were asked to email by August 8, 2022.
  1. The second opportunity for involvement is centered around the ESSENCE user interface re-design project.Software designers with the Johns Hopkins University Applied Physics Laboratory (JHU APL) are redesigning the ESSENCE user interface to incorporate community feedback on the current system. JHU APL has already begun implementing conceptual changes into a prototype user interface (UI). This is an essential phase in the NSSP–ESSENCE capability lifecycle, and both the NSSP team and JHU APL would like user input in the design and development of the new system.Throughout the design phase, NSSP will conduct multiple design iterations so that community members have ample opportunity to provide feedback.
    Time Required: TBD.
    How to Volunteer: JHU APL has invited some community members to participate; if you’ve received an invite, please consider taking part.

Karl closed by informing call participants that Orthopoxviral testing is available in Lab A. NSSP health scientists have categorized both the test and the results in ESSENCE. Sample queries are available in Slack. Please contact NSSP at if you have questions or find these testing data useful. NSSP benefits from hearing positive stories that support the data use.

Group Updates

  • Data Quality Subcommittee:
    • Jade Hodge (KS) reported that in July, the DQ Subcommittee talked about facility type and patient class (the definition and formatting of those fields and ESSENCE usage) and the Office of the National Coordinator for Health Information Technology (ONC) 2022 Standards Version Advancement Process (SVAP). Next month, featured presenter Sophia Crossen, with NSSP’s onboarding team, will explain how to use Associated Facility Settings. The other upcoming presentation will be about data quality, comparing queries to hospital association “gold standard.”
    • The DQ Subcommittee could use a co-lead. If interested, email
    • Wayne Loschen (JHU APL) reminded everyone that they should submit questions on Slack before the workgroup calls to make sure their concerns are addressed. The open-forum session is fast paced and informative.
  • R User Group:
  • Syndromic Surveillance and Public Health Emergency Preparedness, Response, and Recovery Subcommittee (SPHERR):
    • Fatema Mamou (MI) announced a survey that will be sent to SPHERR members to find new date/time for recurring meetings.
    • Focus of August 5 meeting: How jurisdictions set up syndromic surveillance user groups within states to see how people collaborate with each other.
  • Syndrome Definitions (SD) Subcommittee:
    • Rosa Ergas (MA) indicated that members are discussing collaborations and opportunities to review chief complaint/discharge diagnosis (CC/DD) categories being created by the NSSP team.
    • The SD Subcommittee encourages community members to post syndrome definitions they’d like to discuss on Slack.
  • Technical Workgroup:
    • The workgroup is still looking for a co-chair. If interested, please email Caleb Wiedeman (
    • The workgroup is changing its ongoing ticket review strategy. They will assess the newer enhancement requests and only provide input on older requests as needed.
    • Meeting notes are posted in the #technical Slack channel.

Reminders and Announcements

  • Save the date! Planning is underway for the 2022 Syndromic Surveillance Symposium, which will be held virtually three afternoons from December 6–8, 2022.
  • We encourage everyone to make sure your membership information is current. Visit; click on Quick Links; then click Update NSSP CoP Membership. Update your membership preferences to receive calendar invites.
  • The Knowledge Repository (KR) is getting an overhaul. The KR is a popular feature on the NSSP CoP website that contains NSSP CoP call recordings; syndrome library; and resources on data analytics, data sharing, and more. CSTE developers are enhancing the KR search features and user interface with plans to complete the effort later this summer.

NSSP Data Support Local, State, and National Efforts to Monitor Mpox

monkey pox microscope image enhanced

Health scientists with the National Syndromic Surveillance Program (NSSP) and other CDC programs are integral to detecting and monitoring novel and emerging disease. NSSP’s recent efforts have focused on mpox.

NSSP is collaborating with infectious disease experts throughout the agency and with epidemiologists to closely monitor multiple NSSP data sources to improve our understanding of mpox. A description of NSSP’s work is posted at How NSSP Works Across CDC, Improving the Public Health Response.

Syndromic Surveillance Training Series

hands raised with sun cupped in shadow

NSSP is more than ED data. It’s a strategy to integrate near real-time data with other data sources—connecting healthcare with public health.

NSSP has evolved into much more than a platform for conducting syndromic surveillance. It offers dynamic, interactive tools that can improve our understanding of epidemiologic trends and patterns across many public health conditions.

To get data users in the right learning mindset, NSSP and CSTE teams are working with Kahuina Consulting to develop syndromic surveillance curriculum-based training. The series is designed for both novice and advanced learners. If you’ve attended other NSSP CoP trainings facilitated by Kahuina Consulting, you know from experience that these are highly collaborative and informative sessions presented with a healthy dose of purpose and optimism.

If you want to have confidence when acting on your analyses, this course is designed for you. You’ll improve both your foundational understanding of syndromic surveillance methodology and your ability to conceptualize new public health applications.

Our world of syndromic surveillance is evolving. It’s time to get into a new syndromic surveillance state of mind.

August Sys State of Mind header

Explore the common data sources and methods that define SyS practice. Learn how analyst query data and craft syndromes for many public health problems. Apply new knowledge to interactive exercises and simulated experiences, preparing learners to look at public health surveillance through a SyS lens.

July SyS State of Mind icon

Learning Objectives

  1. Describe the general process to categorize records into syndromes
  2. Apply characteristics of SyS data (sources, variables, quality) when describing SyS results
  3. Distinguish between which public health issues are and are not well suited for SyS

Expected Outcomes

  1. Reliably and confidently define a syndrome using typical syndromic surveillance data elements
  2. Reliably and confidently describe representativeness and limitations of SyS results
  3. Accurately frame and/or develop hypotheses for SyS applications

September Expanding Systems header

Identify different SyS analysis methods to support different surveillance and response needs. Learn how to apply a near real-time data source to a diverse set of public health problems, broadening SyS utility. Content for all types of learners, with active engagement, didactic presentations, and action-led micro-learning.

expanding systems icon

Learning Objectives

  1. Select and apply the analysis method as appropriate for the context and health condition of interest
  2. Identify how to utilize SyS data and methods for multiple public health domains

Expected Outcomes

  1. Accurately describe appropriate analytic methods to characterize processed SyS data
  2. Expand SyS application to additional health conditions of interest and public health domains

October Analysys and communication header

Translate data into recommendations and public health actions. Learn how to tell a story through SyS analysis interpretation. Simulated learning experiences are coupled with integrated support tools to maximize best practices.

analysys and communication icon

Learning Objectives

  1. Select appropriate public health actions based on SyS analysis
  2. Describe key messages for various target audiences, including data providers, decision makers, and the public

Expected Outcomes

  1. Determine appropriate response/public health action based on SyS finding
  2. Craft and/or make recommendations for tailored communication per audience profile
Join the NSSP CoP Slack Workspace
Slack Channels

It’s easy to join. And the community is always exchanging ideas, exploring possibilities, and discussing topics relevant to today’s surveillance challenges.

So what are your colleagues discussing?

  • #covid19
  • #data-quality
  • #data-sharing
  • #drug-overdose-use
  • #environmental-health-and-severe-weather
  • #essence-user
  • #general
  • #hospital-admission
  • #lab-data
  • #mortality-data
  • #national-data-requests-sop
  • #nssp-cop
  • #planned-analyses-and-publications
  • #race-and-ethnicity
  • #random
  • #r-user
  • #sas-user
  • #spherr
  • #syndrome-definitions
  • #technical
  • #training
  • #violence-surveillance

Find and Join Channels

  1. Hover cursor over “Channels” on left side of Slack space.
  2. Click the three dots icon that appears next to “Channels” titled “Section Options.”
  3. Select “Browse Channels.”
  4. Find and join any channel that looks interesting!
Data Modernization Initiative

“Modernization” of our public health data and surveillance systems is one way in which CDC invests in the future of public health.

The CDC Public Health Data Modernization Initiative lays out a path to move us toward integrated systems that provide data more efficiently for public health action. This framework guides decisions for allocating resources to create interoperable systems (federal, state, local, and healthcare), coordinate investments across CDC (and with partners), develop next-generation tools (e.g., modeling, visualization, machine learning), and strengthen predictive analytics and forecasting. One objective of DMI is for syndromic surveillance to give a faster understanding of emerging health threats through electronic reporting of emergency department visits.

CDC’s earlier modernization efforts laid the groundwork that supports NSSP’s current approach to surveillance and—bolstered by CDC’s Data Modernization Initiative—positions the program to better protect our country from all types of public health threats.